Guide to Choose a Perfect Pillow For Sound Sleep - Tips by a Physiotherapist

Do you feel pain and stiffness after waking up? Then, the reason behind it can be, disturbed sleep due to bad sleeping posture. Bad sleeping posture can lead to stress and tension in the neck and shoulders because of which the person wakes up with a feeling of discomfort or pain. Therefore it is important to sleep in a proper posture by using a comfortable pillow. A proper pillow supports the head, neck, and shoulders and helps the person have a sound sleep. An experienced physiotherapist can very well guide you to choose the right pillow, by taking a personalized assessment in resting spinal position and recommending the pillow that will optimize the patient’s rest. This blog can help you find out how to choose a proper pillow and when to replace it.

 

Physiotherapy Guide:

A proper pillow helps to maintain the alignment of the body, from the head, neck, spine, and through the spine to the chest, knees, and hips. It also helps in reducing snoring and improves breathing. Insufficient support to the neck and shoulders can put the spine and body, out of alignment, leading to strain and discomfort in the neck, shoulders, and back, resulting in sleeplessness, headaches, and neck pain.

 

Choosing a Proper Pillow

Several factors should be considered while choosing a proper pillow.  Pillows are available in varying sizes and shapes. Few characteristics make a pillow good for use and ensure the prevention of unnecessary strain on the neck and shoulders.

 

Spinal Curvature: A pillow should support the neck while resting, in such a manner that the natural curvature of the spine should maintain bone and muscle health. If the pillow is too high or too low, then it causes the neck to bend abnormally, which can strain the neck and back muscles. It can also cause difficulty in breathing, which is a sleep disturbance.

 

Relaxing: A pillow is used to provide rest and comfort to the person when sleeping. The pillow should be firm, soft, and comfortable, to relax the strained muscles and provide proper sleep.

 

Adaptable: Pillow height varies with sleeping positions, it is better to have pillows that can be adjusted according to the need and sleeping position.

 

Size:

A standard-size pillow is sufficiently large, that's fine, provided the sleeping posture is in alignment. There should be the right amount of thickness, thinness, firmness, and softness of the pillow so that the person can sleep with the head, neck, and shoulders aligned with the spine, as well as provide the right level of support and comfort during sleep.

 

Shapes:

Pillows are also made of various shapes, to provide support and stability for the head and neck. Cervical and contour pillows may help with neck and back pain, and contoured body pillows can provide stability, support, and relief for pressure points along the body.

 

Pillow Materials:

A good pillow is made from a suitable material. Latex, memory foam, and other materials are available in pillows, to provide the best comfort and support for the neck and shoulders. Memory foam pillow conforms to the individual's shape, softens and contours to the lines of the head, neck, and shoulders, and also distributes weight evenly across its surface. Down pillows are light and soft, made of different combinations of down, feathers, and other fillings, these compress around the head and neck's shape so that it is in line with the spine. Whereas latex pillows are more firm than down, but still very comfortable. Polyurethane foam pillows are suitable for all sleep positions, these pillows are responsive without having a viscous feel and have a pressure-relieving quality.

 

Fabric:

Natural, breathable fabrics should be used to cover the pillows. Pillow covers under pillowcases help to extend the life of the pillow, protecting it against stains and sweat.

 

Chemistry:

While selecting a pillow, allergies and chemical sensitivities should be taken into consideration. Synthetic materials like polyester and memory foam are made through chemical processes, and many pillows are put through antimicrobial treatments.

 

Pillow height:

In case of neck pain, a flatter pillow is a better option. Higher pillows create more craniocervical pressure, it is the spot where the head and neck join and also creates a greater cervical angle, i.e the head isn't lined up with the spine. This results in pain and stiffness if the neck stays at this angle all night.

 

Sleeping position affects pillow choice:

Almost everyone keeps on changing the position of sleeping throughout the night. A backside sleeper might also spend some time during the night on the side, the stomach sleeper shifts occasionally to one side. Therefore, a pillow is chosen that works in all sleeping positions.

 

Side sleepers:

Side sleepers need a firm and slightly higher pillow to keep the head in line with the spine, and a pillow with a bump under the neck to support it, also putting a thin pillow between the knees can help keep the spine in line with the head and neck.

 

Stomach sleepers:

Stomach sleepers may need a soft pillow or no pillow at all underneath the head if used a pillow may be kept under the stomach and pelvis which helps to prevent back pain.

 

Back sleepers:

Back sleepers may need a flat and soft pillow, to keep the head and neck in alignment. Back sleepers should use a pillow with a cervical spine curve, i.e a bit of a roll or bump under the neck and a flatter spot for the head.

 

Travelers:

During travel, the head can be kept upright by using a U-shaped travel pillow. This pillow prevents the head from getting angled to the side when sleeping in sitting up.

 

When to replace the Pillow?

Over time, pillows get compressed and lose their shape. Bed pillows should be replaced after 18 months. Memory foam pillows last longer, up to 3 years. Natural pillows tend to last longer than synthetic pillows, and also higher quality pillows last longer than inexpensive ones. To check whether the pillow has life left in it or not, some simple tests can be done:

First, take off the pillowcase and over, and examine it. Does it have stains from sweat? Is it torn? Does it smell? These are various signs of a pillow that needs to be replaced. Pillow collects dead skin cells, mold, fungus, dust mites, etc. which can cause allergies, interfere with breathing during sleep and make it harder to sleep well. The pillow should also be examined by folding it in half. If it lies there folded, rather than springing back to its original shape, then that is a dead pillow. For large, king-size pillows, fold into thirds, rather than in half. If the pillow drapes or hangs down when kept over the extended arm, then it's time to replace it.

When choosing a suitable pillow sleeping habits and personal needs should be taken into consideration as the wrong pillow can lead to headaches, and neck and shoulder pain.

 

Acid Reflux | How Physiotherapy helps in reducing the symptoms of Gastroesophageal Reflux Disease?

If you experience acid reflux frequently and suffer from gastroesophageal reflux disease (GERD) then you may need to do some exercises and make several lifestyle changes.  Exercise may help prevent or relieve the symptoms of acid reflux by helping you lose weight and support good digestion. Your physiotherapist is the professional who can recommend exercises to improve your overall health and increase your quality of life.

 

What is Gastric Reflux?

Acid reflux is a very common condition in which an individual feels burning pain in the lower chest area, known as heartburn. Heartburn happens when the stomach acid flows back up into the food pipe (esophagus). At the entrance of the stomach, there is a valve with a ring of muscles called the lower esophageal sphincter. When the lower esophageal sphincter does not close or open too often after the food passes from the esophagus to the stomach, the stomach acid flows back up to the esophagus causing acid reflux. In severe cases it is called Gastric reflux disease (GERD) a  condition, where small amounts of the stomach contents move upwards into the esophagus and are associated with severe symptoms, it may take up to hours to get rid of the discomfort. Burning pain in the upper chest or abdomen indigestion causes upset stomach, pain is often worse after eating, in the evening, or when lying down or bending over. Some of the early symptoms of acid reflux include dry cough, nausea, vomiting, pain or difficulty while swallowing food, and pain in the upper abdomen. Medication does not resolve the symptoms for all sufferers and long-term use may cause other health issues.

 

Physiotherapy Management

A well-trained and experienced physiotherapist designs a program that suits the individual's needs. Certain exercises can decrease blood flow to the gastrointestinal area, which causes gastric fluids to pool, leading to inflammation and irritation. Also, restrictive body positions can put pressure on the stomach and chest, which may trigger symptoms. Given below is the physiotherapy management for acid reflux patients.

 

Breathing Exercises:

Physiotherapists are trained professionals in breathing exercises, who can help an individual to do exercises correctly to gain the maximum benefit.  Breathing exercises, especially resisted inspiratory breathing exercises, can improve symptoms and reduce reflux. Breathing exercises help to improve diaphragm strength and reduce gastric reflux. Further progressing the exercises by applying resistance to make breathing more difficult can also help in strengthening. It can take more than a month to notice changes in strength and symptoms.

 

Weight loss:

Extra weight may cause acid reflux, it can push against the stomach and affect the lower esophageal sphincter, which can make the symptoms of acid reflux worse. Therefore losing weight is a priority, maintaining a healthy weight helps to reduce or relieve acid reflux symptoms.  For this exercising and also following a suitable diet plan is recommended. Low-impact exercise can lead to weight loss if done consistently. It may take longer to lose weight, but hopefully, an individual will have less reflux along the way.

 

Exercises:

Some types of exercise may make the symptoms worse. Though not everyone experiences worsening acid reflux with high-impact exercise. High-impact exercises such as running, sprinting, weightlifting, gymnastics, cycling, jumping rope, and stair-climbing may cause heartburn. Therefore, low-impact exercises should be tried first and see how an individual feels. If the patient doesn't experience heartburn or other symptoms, then he/she should try doing a higher-impact workout. If any discomfort is experienced, then stick to a low-impact regimen. Low-impact exercises keep an individual as upright as possible such as walking, light jogging, stationary biking, and pilates. But, avoid eating two to three hours before exercising.

 

Cycling:

Bicycling allows one to stay in an upright position, it can be a safe and asymptomatic exercise for sufferers of acid reflux. Cycling can be performed indoors or outdoors. When cycling indoors, a static cycle can be used that allows remaining in an upright position. While cycling outdoors, avoid bumpy terrain as the up-and-down motions can irritate the reflux. While cycling avoids hunching forward on the bicycle. This position places excessive stress on the stomach, which can cause symptoms of acid reflux.

 

Pilates:

With their gentle stretches and slow movements, Pilates can often be easily incorporated into a GERD sufferer's life. Though, the routines need to be modified to avoid triggering acid reflux. Avoid poses that require lying down, bending forward at the waist, or inverting the body. Although it may seem as though these restrictions rule out all Pilates poses, there are still several poses an individual can attempt. During a Pilates session, get the workout with the Plank, Saw, Side Leg Kicks, and Cat pose.

 

Walking:

Walking is good exercise for people with acid reflux. An individual can walk indoors or outdoors on a treadmill, around a track, across a beach, or down the sidewalk, these exercises do not involve excessive movement of the stomach and should not trigger reflux. It is important to stay hydrated and avoid drinking too much water during the walk since walking will cause the stomach contents to slosh around slightly. If the stomach is filled with water, this sloshing could easily lead to acid reflux.

 

Stretching Exercises for the Rib Cage and Sternum to Get Rid of Heartburn:

These exercises can help an individual get rid of the pain and other symptoms. If the pain is still too intense, one should proceed with the program step by step. Make sure to always stretch for 2 to 3 minutes.

• Bring 2 chairs and place them apart so that an individual can reach them with their hands. Place a soft mat between the chairs, kneel on it, and lay the palms on the seats. Be careful so that the arms and back do not form a straight line. The upper body should be positioned lower than the arms.  Then move the upper body to the ground, so that a stretch is felt in the chest and shoulders. Leave the elbows stretched the whole time. Hold this position for 2 to 3 minutes.
• Sit down comfortably on a chair. Take a deep breath and blow all the air out with full force until there is no air in the lungs left.  After exhaling completely, close the mouth and nose with your fingers. Make a move as if trying to suck in the fresh air, even though the mouth and nose are closed. Perform this breathing movement as long as an individual is capable of doing so. Now breathe back in normally and perform this exercise a few times to relax the chest muscles.
• Sit upright in a chair and place a mini ball under the sternum at the xiphoid process, roll in small and spiral-shaped movements along the left and right costal arch. Roll a little lower with each pass and then back to the middle of the chest.

 

Lifestyle modifications:

• Acid reflux symptoms can be reduced or relieved by:
• Eating smaller meals,
• Not lying down after eating,
• Quitting smoking as smoking impairs the lower esophageal sphincter's ability to function properly,
• Avoid wearing tight-fitting clothes or belts around the waist, which can put  pressure on the abdomen,
• Avoid bending over or exercising immediately after a meal, Reduce stress,
• Weight loss may help decrease symptoms, if the individual is overweight,
• Chewing sugarless gum after meals can help to promote saliva production, which neutralizes the acid,
• Some foods that might produce heartburn are fatty, fried, citrus, tomatoes and tomato-based foods, mint, chocolate, coffee, alcohol, and sodas. A food diary should be maintained to record foods that trigger GERD and avoid those foods

 

Sleep modification:

Sometimes sleeping might be difficult when an individual suffers from acid reflux. Therefore, some sleeping positions should be tried that may be preferred to ease the sleeping. Some of them are:

• Elevate the head of the bed about 6 inches with a wedge or by tilting the entire bed, do not use extra pillows to raise the head,
• Large wedge-shaped pillow help alleviate symptoms at night,
• Encourage an individual to sleep on the left side, right side-lying allows the acid to flow into the esophagus more easily,
• Head-up positions minimize reflux and reduce intraabdominal pressure,
• Back sleeping should be avoided,

 

Shaker Head-Lifting Exercise:

An individual should lie in the supine position on a firm and flat surface, without a pillow and arms resting by the sides. The person is asked to breathe slowly and steadily throughout the exercise. The exercise is as follows:

•  Lift the head to look at the toes and hold.
• Only the head lifts, shoulders should be kept flat on the surface.
• Hold this position for 1 minute then the head returns to the starting position.
• Repeat this exercise 2 times, and relax for 1 minute between each repetition.

 

Head Lift and Lower:

• Lift head to look toward the chin and then return to the start position, resembling a sit-up with the head. Repeat this 30 times and relax

Avoid high-impact activities such as jogging or aerobics that cause stomach contents to splash upward. Also avoid exercises that require bending over, laying head-down on an incline or turning upside-down, lying horizontally like swimming, etc. And always take care not to eat before a workout as it can also trigger acid reflux.

 

Disc Herniation | Relieving your Back pain by Physiotherapy

If you suffer from back pain due to herniated disc and are afraid that you might have to live with it. Then it's time for you to relax and get ready to lead a quality life. You can return to your daily routine by availing of Physiotherapy services. Physiotherapy not only helps to enhance the healing process, but reduces pain, and also helps the patient to get back to normal function. This blog will throw some light on the herniated disc and its physiotherapy management.

 

What is a Herniated Disc?

The spine is made up of vertebrae, which are held next to each other by the disc. The disc is a combination of strong connective tissues, made of a strong outer layer, annulus fibrosus, and a gel-like center called nucleus pulposus. The disc may start to lose water content, which makes the disc less effective as a cushion. This may cause herniation through a crack in the outer layer. Disc herniation commonly occurs in the bottom two discs of the lumbar spine. A herniated disc can press on the nerves in the spine and might cause pain, numbness, tingling, or weakness of the leg.

 

Physiotherapy Management:

Physiotherapy management comprises of a number of therapies and techniques like:

 

Cold Therapy:

Herniated disc presses on the nerve in the spinal canal, which causes pain and inflammation along the spinal walls. Cold therapy is found to be effective for pain relief because it constricts the veins along the spine, slowing the circulation and reducing inflammation.

 

Heat therapy:

Heat therapy is a non-invasive pain relief therapy for muscle and joint pain. This therapy is used to promote blood flow, blood helps to heal the area by delivering extra oxygen and nutrients, it removes waste byproducts from muscle spasms reduces pain in the joints, relaxes tight muscles, tendons and ligaments.

 

Kinesio Tape:

Kinesio-tape is a latex-free tape that can be worn for days. Kinesio Tape is applied to the spinal area to facilitate the body's natural healing process while providing support and stability to muscles and joints without restricting the range of motion. It also helps to increase blood flow and reduce pressure on the nerves which helps to decrease pain (localized as well as radiating) and inflammation.

 

Ultrasonic Therapy:

Therapeutic Ultrasound helps to increase blood flow and reduce pain. It uses ultrasonic waves that pass into the skin causing a vibration of local tissues. This vibration causes deep heating in the area without any sensation of heat. As the vibrations created by the ultrasound pass through the soft tissue, this increases heat within the tissue, which in turn increases blood flow, reduces pain, relaxes muscles, increases the extensibility of connective tissues, promotes scar tissue breakdown, and improves flexibility.

 

Vasopneumatic Compression:

Vasopneumatic compression helps to accelerate recovery. It cycles ice-cold water and air through a sleeve which is placed around the affected part of the body. This integrated cold and compression therapy helps to reduce pain, swelling, muscle spasms and enhances lymphatic function and oxygenated blood flow.

 

Transcutaneous Electrical-stimulations:

Transcutaneous electrical stimulations use electrical currents that pass through the electrodes placed directly on the patient's skin. Transcutaneous electrical stimulations cause an increase in the blood flow to promote healing and reduce inflammation. Stimulation act on the pain gate to block the transmission of pain signals, it also causes muscle stimulation for neuromuscular re-education and strengthening.

 

Low-Level Laser Therapy:

Low power laser therapy is effective in the treatment of patients with acute cases of disc herniations. It speeds up the recovery process, decreases inflammation, and pain.

 

Spinal Traction:

Spinal traction is a form of decompression therapy, it helps to relieve pressure from the spine. This type of distraction can be performed with manual techniques as well as machines. Spinal traction is indicated for the treatment of herniated discs, it decompresses spinal discs and facet joints by utilizing traction, distraction, and body positioning.

 

Manual Therapy:

Manipulative treatment for disc herniation is found to be safe, effective, and seems to be as effective as other therapies. It leads to short-term pain relief when suffering from acute low back pain and has an effect similar to NSAIDs. It includes techniques like spinal mobilization, spinal manipulation, massage, myofascial release, etc.

 

Stretching Exercises:

Stretching exercises are included in the treatment plan to decrease soft tissue tightness and improve posture to balance the forces placed on the spine.

 

Strengthening Exercises:

The spine is supported by strong muscles and thus can better handle pain. Core muscle stability is important to regain strength and power. Strengthening exercises help the patient to regain functionality.

 

Treatment of disc herniation is important to control pain, development of disability, prevent a recurrence, and accelerate the return to work. Therefore immediate treatment should be taken before the condition progresses further.